GI History Flashcards
what is the structure of a history and how does it relate to the GI Hx?
HPC - key symptoms
PMH - GI disease and surgery
drug history - drugs, side effects and contraception
family history - inherited
social history - risk factors
travel history - tropical infections and diarrhoea
what are the key GI symptoms for presenting complaint?
abdominal pain dysphasia/oligophasia nausea and vomiting mouth problems appetite and weight gastroesophageal reflux abdominal distention altered bowel habit systemic symtoms
what do you want to know about abdominal pain
socrates
visceral (dull), colic (cyclical), parietal (localised)
what do you want to know about dysphagia/oligophasia
solids vs liquids
what do you need to know about nausea and vomiting
triggers
colour
blood - fresh or coffee
undigested food
what do you need to know about abdominal distention?
fat - obesity flatus - obstruction faeces - constipation fluid - ascites fetus - pregnancy
what do you need to know about altered bowel habit?
constipation
colour - malaena, blood, pale
diarrhoea - consistency, mucous, blood, urgency, recent antibiotics, suspect food, laxatives
what do you need to know about in PMH
diseases: IBD, malignancy, GORD
surgery: appendectomy, colectomy, c-section
what do you need to know about in drug history
drugs: laxatives, loperamide, PPIs, H2 receptor antagonists, gaviscon
side effects:
NSAIDs, steroids, bisphosphonates - erosion
opiates, SSRIs, antacids - constipation
contraception - miscarriage, ectopic
what do you need to know about in family history
malignancy
GORD
IBD
inherited: NPCC (colorectal cancer) and FAP (polyps)
what do you need to know about in social history
alcohol
diet and exercise - constipation
cigarettes and alcohol - dyspepsia
recreational drugs - hep (sexual history)
what do you need to know about in travel history
hepatitis
salmonella
malaria
dirty water
